The pharmaceutical company Lilly have made an announcement on the progress of research into their neutralising antibodies treatment for COVID-19.
Prof Martin Landray, Professor of Medicine & Epidemiology, Nuffield Department of Population Health, University of Oxford, said:
“The monoclonal neutralising antibody drugs are very promising with slightly different versions being developed by several pharmaceutical companies. This announcement from Eli Lilly follows broadly similar results reported by Regeneron last week. Both studies show that monoclonal antibodies targeted at the coronavirus spike protein can reduce the viral load and improve symptoms. Although Eli Lilly report that fewer patients receiving the treatment were admitted to hospital or attended the emergency room than in the placebo group, this should be interpreted with caution in such a small study.
“There is a way to go before we know whether this class of drugs is effective in reducing the worst manifestations of COVID. We need to know if they improve outcomes for patients – avoid hospital admission, shorten hospital stay, reduce need for mechanical ventilation, and improve survival. Furthermore, it is important to establish how well they work in different types of patients (the elderly, particular ethnic groups, those with other disease) and at different stages of the disease (early vs. late, mild vs. severe, requiring oxygen or mechanical ventilation).
“Randomised clinical trials to answer these questions are now a priority. It is encouraging to see that both Eli Lilly and Regeneron have active plans for much larger trials in a range of different settings including residential care homes, outpatients, and hospital inpatients. Here in the UK, the RECOVERY trial has already started to assess the Regeneron antibody combination (so-called REGN-COV2) in patients with COVID in NHS hospitals.”
Prof Stephen Evans, Professor of Pharmacoepidemiology, London School of Hygiene & Tropical Medicine, said:
“These are among the first drugs that have been specifically developed from scratch to work against the SARS-Cov-2 virus. They are attempting to utilise the knowledge of the virus itself and antibodies against it to develop drugs that will attach the virus directly, based on that knowledge. They can be used on their own or in a combination to treat patients, most likely at the earliest possible stage of the disease. The evidence for their efficacy is encouraging but is still limited. There is more evidence that LY-CoV555 monotherapy is effective but it does not mean it is more effective – it is just that it has been studied more.
“The data presented both for LY-CoV555 as monotherapy and in combination with LY-CoV016 are certainly encouraging but at this stage very preliminary. The process of applying for an EUA in the US does not mean that the company have got sufficient data now for the EUA, but will hope to have such data very soon.
“Cautious optimism is justified.”
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Declared interests
Prof Martin Landray: “Co-chief investigator of the RECOVERY trial of potential treatments for COVID-19 (funded by UKRI and NIHR; contributions to supply of study treatment from Abbvie, Roche, and Regeneron).
– Research funding to University of Oxford received from Novartis, Boehringer Ingelheim, and Merck Sharp & Dohme.
– Infrastructure and core funding received from Health Data Research UK, NIHR Oxford Biomedical Research Centre, UK Biobank Ltd, MRC Population Health Research Unit, and British Heart Foundation Centre for Research Excellence.
– Employee of University of Oxford with salary supported by Li Ka Shing Foundation, Health Data Research UK, NIHR Oxford Biomedical Research Centre, Wellcome Trust, and National Health Service.
– I do not accept personal honoraria payments directly or indirectly from the pharmaceutical, biotechnology, or food industries although reimbursement to the University of Oxford for the costs of travel and accommodation to participate in scientific meetings may be accepted. I hold no shares in and receive no consultancy payments directly or indirectly from tobacco, pharmaceutical, biotechnology, or food companies. I comply with the Independence of Research Policy of the Nuffield Department of Population Health, Universityy of Oxford. For details see: https://www.ndph.ox.ac.uk/files/about/ndph-independence-of-research-policy-jun-20.pdf/@@download.”
Prof Stephen Evans: “No conflicts of interest. I am funded (1 day/week) by LSHTM. They get funding from various companies, including Astra Zeneca and GSK but I am not funded by them, I have no involvement in obtaining funding from them and I am not an investigator or any grants obtained from them. I am the statistician to the “meta-Data Safety and Monitoring Board” for CEPI. I will probably be paid for my attendance at meetings and expenses for travel.”